阴道超声对诊断治疗卵巢子宫内膜异位囊肿及子宫腺肌病的价值

目的探讨阴道超声及血清CA125测定对诊断治疗卵巢子宫内膜异位囊肿及子宫腺肌病的价值。方法对卵巢子宫内膜异位囊肿及子宫腺肌病患者631例进行回顾性分析，术前均经阴道超声检查，部分患者进行了血清CA125测定。结果阴道超声检查卵巢子宫内膜异位囊肿符合率98．7％；子宫腺肌病符合率91．7％；卵巢子宫内膜异位囊肿合并子宫腺肌病符合率95．1％。血清CA125检查卵巢子宫内膜异位囊肿，阳性率39．4％；子宫腺肌病阳性率52．2％；卵巢子宫内膜异位囊肿合并子宫腺肌病阳性率59．2％。结论阴道超声可做为较准确诊断卵巢子宫内膜异位囊肿及子宫腺肌病的首选方法。阴道超声下囊肿穿刺是治疗卵巢子宫内膜异位囊肿的简便、有效的方法之一。血清CA125测定可做为卵巢子宫内膜异位囊肿及子宫腺肌病的协助诊断方法，应进一步完善对照组的研究。     

巨噬细胞移动抑制因子在妇科恶性肿瘤中的表达

目的观察妇科恶性肿瘤患者血清、腹腔液中巨噬细胞移动抑制因子(MIF)的表达及其与恶性肿瘤的相关性。方法选择术前未行任何治疗的妇科恶性肿瘤患者46例作为实验组(卵巢癌21例,子宫恶性肿瘤25例),良性肿瘤患者24例为对照组。ELISA法检测术前肘静脉血、术中腹腔液的MIF浓度。同时测定血清血管内皮生长因子(VEGF)及CA125浓度。结果实验组腹腔液MIF的浓度(21.98±11.27 ng/ml)与对照组(13.85±8.11 ng/ml)相比差异显著(P<0.01);而血清MIF浓度(分别为5.13±3.53 ng/ml和3.42±2.06 ng/ml)无明显差异(P>0.05)。卵巢癌患者腹腔液和血MIF的浓度(26.26±11.46 ng/ml,5.52±3.04 ng/ml)分别与良性卵巢肿瘤(11.10±6.68 ng/ml,2.92±1.90 ng/ml)相比,均有显著差异(P<0.001,P<0.01);腹腔液与血清中MIF浓度有相关(r=0.5821,P<0.01);腹腔液MIF浓度与血CA125有关联(r=0.6649,P<0.05),与血清VEGF也相关(r=0.405,P<0.05)。子宫恶性肿瘤患者腹腔液和血清MIF的浓度(18.20±8.67 ng/ml和4.68±3.24 ng/ml)与子宫肌瘤(17.24±6.32 ng/ml和2.8±2.20 ng/ml)相比,均无差异(均P>0.05)。结论卵巢癌患者腹腔液与血清均有MIF表达,而腹腔液MIF呈高表达,可能与CA125类似,主要源于肿瘤组织。MIF与VEGF可能存在互相诱导分泌的关系。     

血清和腹腔液CA125测定与子宫内膜异位症诊断的相关分析

目的:探讨不孕症患者术前血清及术中腹腔液CA125浓度与诊断子宫内膜异位症(EM)的关系。方法:对129例因疑输卵管性不孕而行腹腔镜或宫腹腔镜联合手术的患者,于术前抽取血清,术中抽取腹腔液测CA125浓度。根据血清CA125值分为<10U/ml、10-15U/ml、16-34U/ml和≥35U/ml4组,分析各组血清和腹腔液中CA125浓度与EM诊断的相关性。结果:血清CA125水平<10U/ml和≥16U/ml时,EM的诊断符合率分别为9.09%和89.55%,两组比较有显著差异(P<0.01)。腹腔液<800U/ml和≥800U/ml的EM诊断符合率分别为19.23%和94.80%,两组比较有显著差异(P<0.01)。血清CA125≥10U/ml结合腹腔液CA125≥800U/ml的诊断符合率为93.42%。结论:血清CA125≥10U/ml结合腹腔液CA125≥800U/ml对EM的诊断有重要参考价值。     

血清CEA、CA19-9和CA72-4联合检测诊断结直肠癌的临床研究

目的:探讨CEA、CA19-9和CA72-4在结直肠癌诊断中的应用价值。方法:应用微粒子发光法测定CEA、CA19-9及CA72-4。共测定60例健康成人及87例结直肠癌患者血清。结果:CEA、CA199及CA724单个肿瘤标志物诊断结直肠癌的敏感性分别为44．9％(39／87)、39．1％(34／87)及34．5％(30／87),特异性分别为93．3％(56／60)、96．7％(58／60)及95．0％(57／60);CEA联合CA199、CEA联合CA724、CEA联合CA199和CA724不同组合诊断结直肠癌的敏感性分别为55．2％(48／87)、59．8％(52／87)及67．8％(59／87),特异性分别为90．0％(54／60)、88．3％(52／60)及85．0％(51／60)。其中三种肿瘤标志物联合检测敏感性显著高于单一标志物检测(P<05)结论:CEA、CA199和CA724单个肿瘤标志物诊断结肠癌敏感性较差,几种肿瘤标志物联合检测可以明显提高诊断结直肠肿瘤的敏感性和有效性。     

Oxytocin receptor agonists enhance inhibitory synaptic transmission in the rat hippocampus by activating interneurons in stratum pyramidale

Oxytocin probably plays a role as a neurotransmitter/neuromodulator in the hippocampus of the rat. Oxytocin binding sites are present in the subiculum and CA1 region and oxytocin can excite a class of CA1 nonpyramidal neurons. In the present work we characterized the effect of oxytocin on hippocampal synaptic transmission. Whole-cell recordings were obtained from pyramidal neurons, in conditions of nearly symmetrical chloride concentrations. The selective oxytocin receptor agonist, [Thr4,Gly7]-oxytocin (TGOT), caused an increase in the frequency and amplitude of spontaneous inhibitory postsynaptic currents (IPSCs) in virtually all neurons. These peptide-enhanced IPSCs were blocked by bicuculline, but not by strychnine, and reversed near 0 mV, indicating that they were mediated by gamma-aminobutyric acid (GABA)A receptors. On average, TGOT caused a nearly threefold increase in the frequency and almost a doubling in the amplitude of spontaneous IPSCs. TGOT did not influence the frequency and the amplitude of miniature IPSCs or spontaneous excitatory postsynaptic currents (EPSCs), and had no effect on evoked IPSCs. The peptide did not affect the basic membrane properties of pyramidal neurons or their GABA sensitivity. Thus, TGOT facilitated inhibitory transmission by exerting an excitatory action on the soma and/or dendrites of GABAergic interneurons. Extracellular recordings were performed in interneurons located in various hippocampal strata. Their sensitivity to TGOT was compared to that of substance P (SP). Interneurons in stratum pyramidale were excited both by TGOT and by SP. By contrast, stratum radiatum interneurons responded to SP but not to TGOT. In stratum oriens, half of the interneurons responded to SP, but only a minority to TGOT. Thus, oxytocin-responsive interneurons appear to be preferentially located in close vicinity of pyramidal neurons.     

GPDA 、CA72-4 、CA50 联检在胃癌诊断中的价值

 目的 探讨GPDA、CA72-4、CA50三项联检对胃癌的临床诊断价值。方法 采用电化学发光免疫分析、放射免疫法及全自动生化分析仪等技术，对125例胃癌、77例胃良性疾病、50例正常健康人血清进行GPDA、CA72-4、CAS0三项检测。结果 胃癌组GPDA、CA72-4、CA50敏感性分别为62．4％、68．0％，54．4％；特异性分别为97．6％、97．6％、98．4％。三项联检敏感性提高到89．6％，与单检比较有统计学意义（P〈0．05）；同时特异性并未明显降低，仍有93．7％。结论 GPDA、CA72-4、CA50可作为临床诊断胃癌的肿瘤标志物，三项联检可明显提高阳性检出率。     

An analysis of foetal craniofacial growth

280 male foetuses aged 4–10 lunar months were obtained from therapeutic abortions. Growth of the craniofacial skeleton was determined from measurement of sagittal radiographs. Univariate and multivariate analysis of the data showed considerable size changes during the foetal period but relatively little change in overall shape.     

Impact of Margin Status on Survival in Patients with Pancreatic Ductal Adenocarcinoma Receiving Neoadjuvant Chemotherapy

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Heterogeneity of Age-Related Neural Hyperactivity along the CA3 Transverse Axis

Age-related memory deficits are correlated with neural hyperactivity in the CA3 region of the hippocampus. Abnormal CA3 hyperactivity in aged rats has been proposed to contribute to an imbalance between pattern separation and pattern completion, resulting in overly rigid representations. Recent evidence of functional heterogeneity along the CA3 transverse axis suggests that proximal CA3 supports pattern separation while distal CA3 supports pattern completion. It is not known whether age-related CA3 hyperactivity is uniformly represented along the CA3 transverse axis. We examined the firing rates of CA3 neurons from young and aged, male, Long–Evans rats along the CA3 transverse axis. Consistent with prior studies, young CA3 cells showed an increasing gradient in mean firing rate from proximal to distal CA3. However, aged CA3 cells showed an opposite, decreasing trend, in that CA3 cells in aged rats were hyperactive in proximal CA3, but possibly hypoactive in distal CA3, compared with young (Y) rats. We suggest that, in combination with altered inputs from the entorhinal cortex and dentate gyrus (DG), the proximal CA3 region of aged rats may switch from its normal function that reflects the pattern separation output of the DG and instead performs a computation that reflects an abnormal bias toward pattern completion. In parallel, distal CA3 of aged rats may create weaker attractor basins that promote abnormal, bistable representations under certain conditions.SIGNIFICANCE STATEMENT Prior work suggested that age-related CA3 hyperactivity enhances pattern completion, resulting in rigid representations. Implicit in prior studies is the notion that hyperactivity is present throughout a functionally homogeneous CA3 network. However, more recent work has demonstrated functional heterogeneity along the CA3 transverse axis, in that proximal CA3 is involved in pattern separation and distal CA3 is involved in pattern completion. Here, we show that age-related hyperactivity is present only in proximal CA3, with potential hypoactivity in distal CA3. This result provides new insight in the role of CA3 in age-related memory impairments, suggesting that the rigid representations in aging result primarily from dysfunction of computational circuits involving the dentate gyrus (DG) and proximal CA3.     

The care of VIPs in the emergency department: Triage,treatment and ethics

People identified as Very Important Persons (VIPs) often present or are referred to the Emergency Department (ED). Celebrities are a small subset of this group, but many others are included. Triage of these patients, including occasional prioritization, creates practical and ethical challenges. Treatment also provides challenges with the risks of over testing, overtreatment, over consultation, and over or under admission to the hospital. This article presents a practical and ethical framework for addressing the care of VIPs in the ED.